The role of metabolic disorders in the formation of urolithiasis in patients with type 2 diabetes mellitus

Abstract

The article presents the study of the influence of type 2 diabetes mellitus on the features of the urolithiasis development and factors affecting stone formation. As part of the study, 28 patients with type 2 diabetes mellitus were treated at the «Regional Medical Clinical Center of Urology and Nephrology named after V. I. Shapoval», where a comprehensive examination was carried out to determine the level of glycosylated hemoglobin, glomerular filtration rate, serum concentration of triglycerides, urea, creatinine and uric acid. All patients underwent ultrasound examination of the urinary system organs. In case of detecting stones in the kidneys or urinary tract, multispiral computed tomography with contrast was performed, which evaluated the size, localization and X-ray density of the stones. Depending on the above parameters, patients underwent extracorporeal shock wave lithotripsy, contact laser ureterolithotripsy or percutaneous nephrolithotripsy, followed by assessment of the mineral composition of the obtained stone fragments by infrared spectroscopy. The study revealed a positive correlation between the level of uric acid in the blood and the duration of diabetes mellitus both in men (r = 0.64, р < 0.05) and in women (r = 0.58, р < 0.05), while the concentration of uric acid in the blood did not depend on the age and gender of the patients. There was a direct relationship between hyperuricemia and the concentration of glycosylated hemoglobin. The level of uricemia increased simultaneously with the level of creatinine in the blood. Urolithiasis was diagnosed in 67.8% of the examined patients. There was a significant increase in the number of cases of urolithiasis with an increase in the duration of diabetes mellitus (r = 0.64, p < 0.05). In 68.4% of patients, stones had a monophasic composition, which was represented by uric acid or uric acid dihydrate. In 31.5% of cases, stones had a mixed mineral composition, with uric acid being the dominant component, occupying more than 50% of the sample volume